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      Clinical utility of urine specific gravity, electrical conductivity, and color as on‐farm methods for evaluating urine concentration in dairy cattle

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          Abstract

          Background

          Urine concentration (UC) provides clinically useful information concerning hydration status and renal function of animals.

          Objectives

          To characterize the clinical performance of urine specific gravity measured by optical refractometry (U SG‐R) or Multistix‐SG urine reagent dipstick (U SG‐D), urine electrical conductivity using an OAKTON Con 6 conductivity handheld meter (U EC), urine color (U Color) using a custom‐designed 8‐point color chart, and urine creatinine concentration (U Creat) for assessing UC in dairy cattle.

          Animals

          20 periparturient Holstein‐Friesian cows.

          Methods

          Urine was obtained by perineal stimulation or urethral catheterization and urine osmolality (U Osm, reference method), U SG‐R, U SG‐D, U EC, U Color, and U Creat determined. Diagnostic test performance was evaluated using Spearman's rho and logistic regression to determine the area under the receiver operating curve (AUC) and optimal cut point for diagnosing hypohydration (U Osm ≥800 mOsm/kg). P < .05 was considered significant.

          Results

          The best performing test for diagnosing hypohydration was U SG‐R (AUC = 0.90) at an optimal cut point ≥1.030. The second‐best performing test was U EC (AUC = 0.82) at a cut point of ≥23.7 mS/cm, followed by U Creat (AUC = 0.76) at a cut point of ≥95.3 mg/dL, and U Color (AUC = 0.74) at a cut point of ≥4 on an 8‐point scale. Urine specific gravity measured by dipstick performed poorly (AUC = 0.63).

          Conclusions and Clinical Importance

          U SG‐R and U EC provide practical and sufficiently accurate methods for measuring UC in dairy cattle. Urine color had moderate clinical utility as a no‐cost cow‐side method for assessing UC, whereas dipstick refractometry is not recommended for assessing UC.

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          Most cited references47

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          Measuring the accuracy of diagnostic systems.

          J Swets (1988)
          Diagnostic systems of several kinds are used to distinguish between two classes of events, essentially "signals" and "noise". For them, analysis in terms of the "relative operating characteristic" of signal detection theory provides a precise and valid measure of diagnostic accuracy. It is the only measure available that is uninfluenced by decision biases and prior probabilities, and it places the performances of diverse systems on a common, easily interpreted scale. Representative values of this measure are reported here for systems in medical imaging, materials testing, weather forecasting, information retrieval, polygraph lie detection, and aptitude testing. Though the measure itself is sound, the values obtained from tests of diagnostic systems often require qualification because the test data on which they are based are of unsure quality. A common set of problems in testing is faced in all fields. How well these problems are handled, or can be handled in a given field, determines the degree of confidence that can be placed in a measured value of accuracy. Some fields fare much better than others.
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            Urinary indices of hydration status.

            Athletes and researchers could benefit from a simple and universally accepted technique to determine whether humans are well-hydrated, euhydrated, or hypohydrated. Two laboratory studies (A, B) and one field study (C) were conducted to determine if urine color (Ucol) indicates hydration status accurately and to clarify the interchangeability of Ucol, urine osmolality (Uosm), and urine specific gravity (Usg) in research. Ucol, Uosm, and Usg were not significantly correlated with plasma osmolality, plasma sodium, or hematocrit. This suggested that these hematologic measurements are not as sensitive to mild hypohydration (between days) as the selected urinary indices are. When the data from A, B, and C were combined, Ucol was strongly correlated with Usg and Uosm. It was concluded that (a) Ucol may be used in athletic/industrial settings or field studies, where close estimates of Usg or Uosm are acceptable, but should not be utilized in laboratories where greater precision and accuracy are required, and (b) Uosm and Usg may be used interchangeably to determine hydration status.
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              Urinary indices during dehydration, exercise, and rehydration.

              This investigation evaluated the validity and sensitivity of urine color (Ucol), specific gravity (Usg), and osmolality (Uosm) as indices of hydration status, by comparing them to changes in body water. Nine highly trained males underwent a 42-hr protocol involving dehydration to 3.7% of body mass (Day 1, -2.64 kg), cycling to exhaustion (Day 2, -5.2% of body mass, -3.68 kg), and oral rehydration for 21 hr. The ranges of mean (across time) blood and urine values were Ucol, 1-7; Usg, 1.004-1.029; Uosm, 117-1,081 mOsm x kg-1; and plasma osmolality (Posm), 280-298 mOsm x kg-1. Urine color tracked changes in body water as effectively as (or better than) Uosm, Usg, urine volume, Posm, plasma sodium, and plasma total protein. We concluded that (a) Ucol, Uosm, and Usg are valid indices of hydration status, and (b) marked dehydration, exercise, and rehydration had little effect on the validity and sensitivity of these indices.
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                Author and article information

                Contributors
                constabl@illinois.edu
                Journal
                J Vet Intern Med
                J. Vet. Intern. Med
                10.1111/(ISSN)1939-1676
                JVIM
                Journal of Veterinary Internal Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                0891-6640
                1939-1676
                25 April 2019
                May-Jun 2019
                : 33
                : 3 ( doiID: 10.1111/jvim.2019.33.issue-3 )
                : 1530-1539
                Affiliations
                [ 1 ] Department of Veterinary Clinical Medicine, College of Veterinary Medicine University of Illinois at Urbana‐Champaign Champaign Illinois
                [ 2 ] Department of Animal Medicine, Internal Medicine, Faculty of Veterinary Medicine Benha University Benha Egypt
                [ 3 ] Clinic for Cattle University of Veterinary Medicine Hannover, Foundation Hannover Germany
                Author notes
                [*] [* ] Correspondence

                Peter D. Constable, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana‐Champaign, 2001 S. Lincoln Ave, Urbana, IL 61802.

                Email: constabl@ 123456illinois.edu

                Author information
                https://orcid.org/0000-0003-2006-8873
                https://orcid.org/0000-0003-1929-2106
                Article
                JVIM15502
                10.1111/jvim.15502
                6524117
                31025445
                3f0b41c6-dc32-40dc-be91-1100550c90bf
                © 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 24 December 2018
                : 03 April 2019
                Page count
                Figures: 7, Tables: 1, Pages: 10, Words: 7500
                Categories
                Standard Article
                FOOD AND FIBER ANIMAL
                Standard Articles
                Immunology
                Custom metadata
                2.0
                jvim15502
                May/June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.3 mode:remove_FC converted:17.05.2019

                Veterinary medicine
                bovine,dehydration,hypohydration,refractometer,urine color chart,urine creatinine,urine dipstick

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